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1578558714
ALEXANDER T GEDEVANISHVILI
LAGRANGE, GA
NPI
1578558714
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: GA 054099)
Enumeration Date
2005-09-14
Last Update Date
2019-11-05
Business Address
ALEXANDER T GEDEVANISHVILI M.D.
1602 VERNON RD STE 300
LAGRANGE, GA 30240
Phone number: 706-242-5100
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Mailing Address
ALEXANDER T GEDEVANISHVILI M.D.
805 SANDY PLAINS ROAD MEDICAL STAFF SERVICES
MARIETTA, GA 30066-6340
Phone number:
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